Hepatitis B virus reactivation in HBsAg-positive patients with rheumatic diseases undergoing anti-tumor necrosis factor therapy or DMARDsopen access
- Authors
- Lee, Young Ho; Bae, Sang-Cheol; Song, Gwan Gyu
- Issue Date
- Oct-2013
- Publisher
- WILEY-BLACKWELL
- Keywords
- anti-tumor necrosis factor therapy; DMARD; hepatitis B virus reactivation; rheumatic diseases
- Citation
- INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, v.16, no.5, pp.527 - 531
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES
- Volume
- 16
- Number
- 5
- Start Page
- 527
- End Page
- 531
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/26628
- DOI
- 10.1111/1756-185X.12154
- ISSN
- 1756-1841
- Abstract
- Objective
The aim of this study was to assess the effects of anti-tumor necrosis factor (TNF) agents or disease-modifying antirheumatic drugs (DMARDs) on hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-positive patients with rheumatic diseases.
Methods
Evidence of HBV reactivation after anti-TNF therapy or DMARDs in HBsAg-positive patients with rheumatic disease was summarized by performing a systematic review.
Results
A total of 122 HBsAg-positive rheumatic disease-positive patients undergoing treatment with an anti-TNF agent or with DMARDs were identified in nine studies. In eight of the studies, the anti-TNF agents used were etanercept in 56 cases, adalimumab in 25 cases and infliximab in 14 cases. Follow-up periods ranged from 6 to 52 months. Antiviral prophylaxis was administrated in 48 of the 122 patients (39.3%). HBV reactivation in HBsAg-positive patients taking an anti-TNF agent or DMARD was reported in 15 cases (15/122 = 12.3%). Ten of the 15 patients provided individual data on HBV reactivation: four patients had rheumatoid arthritis, four had ankylosing spondylitis and two had psoriatic arthritis; four received etanercept, and two received infliximab. In one of the four etanercept-treated cases in which the patient had elevated HBV-DNA levels, antiviral prophylaxis was also administered. Antiviral treatment was also administered in seven patients receiving other treatments: lamivudine in one, adefovir in one and entecavir in five. Clinical outcomes were satisfactory in all 10 cases of HBV reactivation.
Conclusions
Hepatitis B virus reactivation was found in 15 (12.3%) patients among the 122 HBsAg-positive patients with rheumatic diseases treated with anti-TNF agents or DMARDs.
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